What Is a Frontal Lobe Brain Tumor?

Frontal tumors are common intracranial tumors, and their incidence rate is the highest among tumors in various parts of the scene, accounting for about 1/5 of the total number of intracranial tumors. Glioma is the most common, accounting for about 1/4 of the total number of intracranial gliomas; followed by meningioma, which accounts for about 1/10 of the total number of intracranial meningiomas; congenital tumors, metastatic tumors, etc. This part happens.

Basic Information

English name: frontal tumour
Visiting department: Oncology

Common locations: Frontal lobe
Common symptoms: Headache, vomiting, lack of concentration, memory and understanding loss, seizures

Causes of brain frontal lobe tumors

The cause is not completely clear. There are oncogenes on cell chromosomes plus various acquired factors that can cause it to occur. The possible factors that induce this disease are: genetic factors, physical and chemical factors, and biological factors.

Brain frontal lobe tumor clinical manifestations

1. Symptoms and signs of increased intracranial pressure

Mainly headache, vomiting and edema of the optic nerve head.

Mental symptoms

Early symptoms of patients often manifest as inattention, loss of memory and comprehension, especially near memory loss, and distant memory preservation. As the disease progresses, thinking and comprehensive abilities are obviously lost, and far and near memory are gradually disappearing. Loss of self-awareness and judgment, disorientation of time and place, and the patient gradually becomes dementia. Personality changes are also very common, mainly manifested as mental retardation, indifferent expression, indifferent to surroundings, unknowing, lazy life, and some patients show loss of ability to suppress, easily excited, grumpy, cheerful, witty, naive. , Childlike dementia, frivolous, stupid, boring jokes, even crying and laughing, sometimes showing enthusiasm or even anger, such as erect hair, rising blood pressure, dilated pupils and accompanied by aggressive actions.

3. Seizures

In frontal tumors, seizures are often the first symptom. When the tumor invaded the cerebral cortex 6 and 8 of the frontal lobe, the seizures were mostly consciously lost. The head and eyes turned to the opposite side of the lesion, the upper and lower limbs were twitched on the opposite side of the lesion, and the upper limbs were obvious. The seizures in a few patients only ended here, but Most followed by a generalized seizure. Frontal-bottom tumors, especially near the midline of the bottom, can cause systemic spasms as the tumor develops to the sides, mostly due to increased intracranial pressure, and localized seizures can also occur when the tumor invades and central anterior gyrus.

4. Symptoms of cone bundle damage

In the frontal tumor, the weakening of the contralateral abdominal wall and cremaster test reflex disappears and the simultaneous ankylosing plantar flexion reflex is often an early symptom. As the tumor continues to grow and invades the motor area, muscles can appear on the contralateral side of the lesion. Increased tension, hypertenoid reflexes, and often accompanied by ankle clonus, palatal clonics, etc., and finally different degrees of paralysis on the opposite side of the lesion. Babinski sign is a representative important sign of cortical spinal cord lesions, especially when talking and laughing, so it is considered one of the important signs of frontal tumors.

5. Motor aphasia

Patients with a dominant right hemisphere, such as tumor invasion and Broca in the posterior subfrontal gyrus, can cause aphasia. The patient's lips and tongue can move freely and understand other people's languages, but they cannot use words to talk to others. There is no obstacle in the movement of the articulating organs, and some of them can pronounce but cannot constitute language. Patients with less damage often have incomplete motor aphasia. Patients can still make individual speech, speak slowly, often make typos or appear language pauses, stuttering; in severe cases, they completely lose the ability to speak. When the tumor affects the posterior midfrontal gyrus of the superior hemisphere, it can cause writing failure. The patient can speak, understand, and understand, but loses the ability to write.

6. Frontal Ataxia

Frontal lobe tumors can appear similar to cerebellar-derived ataxia. In the early stage of frontal tumors, especially frontal pole tumors, there is no dyskinesia or paralysis if it is not accompanied by an increase in intracranial pressure, but complex and sophisticated advanced dyskinesias can occur. A tremor appears on the contralateral hand of the lesion, and there is a slight ataxia in the lower extremities. It is not easy to observe by general observation. It can occur when the patient is instructed to take a quick walk or make a quick turn. About half of the patients with frontal lobe damage can have ataxia. When the frontal lobe is damaged on both sides, the patient's gait fluctuates. When the side is significantly damaged, the lower limb of the opposite side of the lesion is significantly awkward and often walks excessively Step outside, but such patients with poor discrimination and continuous motor dysfunction are often not significant, and often without nystagmus.

7. Groping motion of strong grip reflection

Frontal lobe tumor damage, especially when the frontal gyrus is close to the central anterior gyrus, due to the loss of control over voluntary movements, when the object touches the fingers of the contralateral finger and the palm of the hand, it causes the fingers and palm to flex and grasp the object tightly The phenomenon of holding hands is called strong grip reflex; when the palm of a patient is touched by an object, both hands and upper limbs are moved toward the object. If the palm of the patient is continuously touched, the upper limbs can be explored to all sides until it touches the object. Holding this object is called groping motion. Strong grip reflex and groping motion occur on one side at the same time, which is often an important basis for diagnosing frontal tumors.

8. Other symptoms

When the frontal lobe tumor is located at or near the frontal base, it can affect or compress the olfactory nerve, leading to loss of olfactory sense. The tumor can compress the optic nerve on one side, and the disease can cause primary atrophy of the optic nerve on the side. Edema, patients with tumors on the medial frontal lobe sometimes have urinary incontinence or urinary urgency, resulting in panic urination, or even incontinence of bowel movements, bifrontal tumors or tumors invading the central anterior gyrus, sometimes with suction reflexes or pouting reflexes Deep-leaf tumors may occasionally show extrapyramidal symptoms, with slight contralateral limb tremor, and frontal tumors may appear stiff, and patients can remain in a fixed state for a long time without fatigue; bulimia may occur in a few patients. Hypersexuality and so on.

Brain Frontal Lobe Tumor Examination

Plain skull

A plain radiograph of the skull can be used for localized or qualitative diagnosis of certain frontal tumors. For example, oligodendrocyte tumors sometimes show calcified plaques, which are often characterized by cord-like, spot-like or lumpy, interlaced calcium plaques. ; Astrocytomas, calcifications mostly occur in the cyst wall or tumor body of the tumor, and the calcifications are mostly arc-shaped, cord-like, flaky, or spotted; ependymal tumors are common in the lateral ventricle, and spotted calcification is common The calcification of meningiomas often shows large clumps, higher density, and clear outlines. Sand-granular meningiomas calcifications are the most common. Frontal gliomas, meningiomas, and metastases can be absorbed and changed when they are close to the skull. Thin, damaged and defective. In addition, meningiomas are also commonly associated with skull hyperplasia. When frontal lobe tumors cause an increase in cranial pressure, there can be increased brain pressure traces, cracks in the cranial sutures, and changes and displacement of the sphenoid bone.

Internal carotid angiography

Frontal lobe tumors mainly result in the upper segment of the internal carotid artery, the anterior 2/3 of the anterior cerebral artery, and the initial segment of the middle artery. Vascular displacement and deformation occur in different directions and to different degrees from the ascending frontal artery.

3. Ultrasound

During ultrasound examination of frontal tumors, the midline wave showed a moderate shift to the healthy side. Forefront, frontal, and double frontal tumors, the midline wave did not shift, but tumor pathological waves of varying degrees and tumor compression space appeared. Obstruction caused by obstructive hydrocephalus, can show increased ventricular wave amplitude, the distance between the lateral ventricular wave and the midline wave becomes larger, you can speculate the degree of hydrocephalus.

4. EEG

The EEG examination of frontal tumors has the following characteristics: The incidence of localized delta waves is about 83% higher. 40% showed unilateral or bilateral paroxysmal single rhythmic delta waves, especially the tumors on the medial or basal surface of the frontal lobe. About 1/3 of the contralateral frontal tumors in unilateral frontal tumors also have a spreading wave, but the general amplitude is low and often becomes a mixed wave. The background wave is normal in 1/3 of the cases. In this case, the further forward the tumor is, the less abnormal the alpha is. Bilateral frontal tumors are characterized by the appearance of independent polymorphic delta waves in the bilateral frontal regions. The larger side of the tumor is more pronounced.

5. Skull CT examination

CT mainly diagnoses intracranial tumors by comparing the density of the tumor with surrounding tissues and the displacement and deformation of normal structures (such as the ventricles of the brain). Frontal tumors are usually gliomas and meningiomas, which usually show high density; common anterior horns of the lateral ventricle Compression deformation.

6. Head MRI

Combined with CT, it improves the detection rate of tumors and helps to characterize tumors.

Brain frontal tumor diagnosis

Diagnosis can be confirmed based on medical history, clinical symptoms, and auxiliary examinations such as skull CT and MRI.

Brain frontal lobe tumor treatment

Reduce intracranial pressure

dehydration treatment; external drainage of cerebrospinal fluid; comprehensive preventive measures.

2. Surgical treatment

tumor resection; internal decompression surgery; external decompression surgery; cerebrospinal fluid shunt surgery.

3. Radiotherapy

Patients with systemic conditions do not allow surgical resection and patients with intracranial tumors that are more sensitive to radiation therapy. Radiotherapy can be used to delay tumor recurrence or inhibit tumor growth and prolong patient life.

4. Chemotherapy

5. Gene Therapy